The primary endpoint assessed the reduction in HMB compared to placebo as measured by the alkaline hematin
method, an objective measurement of total menstrual blood loss (MBL) based on quantification of menstrual blood collected on sanitary products.
A response was defined as a menstrual blood loss volume of less than 80 mL and a 50% or greater reduction from baseline in menstrual blood loss volume during the last 35 days of treatment measured using the alkaline hematin
The classic patient enrolled had regular, predictable, heavy menstrual cycles with alkaline hematin
assay of greater than 80.
The setup is left aside for 10 min to enable the formation of acid hematin
. Then, distilled water is put into this tube drop by drop.
1 After rupture of blood vessels, the blood will penetrate the tubules of dentin and its consecutive break down will lead to different chromogenic degradation products like hematoidin, hemine, hemosiderin and hematin
. 1, 5 Added to that, pulp extirpation can generate hemorrhage in the pulp chamber.
is a ferriprotoporphyrin-IX with a hydroxide ion bound to the ferric ion formed when hemin (ferriprotoporphyrin-IX with a chloride ion bound to ferric ion) is treated with strong NaOH solution.
Transfusion of erythrocytes, intravenous hematin
and oral activated charcoal, bone marrow transplant and gene therapy is also advocated.5,6 In our case, sun protection in the form of broad spectrum sunscreen, beta carotene, protective eye goggles were advised.
Stigmata of recent hemorrhage were defined according to Forrest classification as follows: Forrest la, spurting bleeding; Forrest lb, oozing bleeding; Forrest Ha, non-bleeding visible vessel; Forrest lib, adherent clot; Forrest lie, hematin
on ulcer base; and Forrest III, clean ulcer base (16).
Patients were included if they were premenopausal, aged 18-50 years old, had prolonged bleeding in at least 4 of the last 6 menstrual periods, had menstrual blood loss of at least 80 mL by cycle by the alkaline hematin
method, and had at least one discrete leiomyoma without a uterine size greater than 20 weeks.
Tappel, The Mechanism of the Oxidation of Unsaturated Fatty Acids Catalyzed by Hematin
The time period until the high porphobilinogen levels suggested that the attack began to decline and thus hematin
could not be easily obtained.
As per blood bank protocol, hemoglobin of all prospective blood donors which include replacement donors (relatives and friends), family replacement donors (family members) and voluntary donors was initially screened by copper sulfate solution specific gravity method followed by alkaline hematin
method for recording hemoglobin level.